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460 ~ 4 April 2006

460 ~ 4 April 2006. Still no handout / notes from: Saw Palmetto : McDonagh to Persico ? Module VII – Integrative Approaches re Common Health Issues: ~ GI system today ~ chronic fatigue & oncology next day. Tomorrow ….

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460 ~ 4 April 2006

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  1. 460 ~ 4 April 2006 • Still no handout / notes from: Saw Palmetto: McDonagh to Persico ? • Module VII – Integrative Approaches re Common Health Issues: ~ GI system today ~ chronic fatigue & oncology next day

  2. Tomorrow … • … Wednesday of this week, at two minutes and three seconds after 1:00 in the  morning, the time and date will be 01:02:03 04/05/06That won't  ever happen again

  3. T h e G I S y s t e m You are what you eat, Or, You are what you ingest, And . . . what you can’t ingest ?

  4. Bodily Systems

  5. 1. Abu-Romeh to Blanchette 2. Blommers to Connor 3. Crowther to Eastwood 4. Fabian to Geddis 5. Girvan to Hudders 6. Jagielnik to Korczynski 7. Kusmider to Mazur 8. McDonagh to Persico 9. Pone to Sklazeski 10. Snider to Zettler GI Groups Groups 1 – 3 What is the GI system, how does it work ? Groups 4 – 6 How do we care for it & what goes wrong ? Groups 7 – 10 What are possible CAM preventions/therapies ?

  6. GI Components • Esophagus • Stomach • Duodenum • Small bowel • Colon • Liver and biliary system • Spleen • Pancreas • GI - Other

  7. Functions of GI System • Broadly: ingest, digest, absorb food • Immune surveillance & response • Detoxification • Neuro-endocrine regulation

  8. gland Esophagus Stomach Small Intestine Large Intestine

  9. Digestive function support by • Mastication • Peristalsis • Enzymes & secretions that facilitate enzymes’ functions

  10. Absorptive function facilitated by • Immense surface area of small intestine (villi and microvilli) • Active transport and diffusion (transmucosal, energy-driven processes) along entire lengths of small and large intestines

  11. diseases  • radiological findings,  • differential-diagnosis lists   • pertinent anatomy, pathology, and physiology

  12. Esophageal Issues

  13. “every centimeter of GI tract is colonized by bacteria…every meal bathes this surface with antigens, organisms, & active substances derived from food & drink” [text]

  14. The GI’s Strategy of Digestion

  15. GI Slide: Kids can slide and crawl through a giant 3D model of the digestive system from mouth to large intestine.  This exhibit is 8’ high and over 30’ long Sudbury’s Science North

  16. A brief travel thru main components of GI tract . . .

  17. The Oesophagus

  18. The Stomach

  19. The Stomach Histology

  20. The Small Intestine • Duodenum • Jejunum • Ileum

  21. The Small Intestine ~ The Jejunum

  22. The Pancreas • structurally, the pancreas has four sections; head, neck, body and tail; the tail stretches back to just in front of the spleen. • The pancreas consists mainly of exocrine glands that secrete enzymes to aid in the digestion of food in the small intestine. the main enzymes produced are lipases, peptidases and amylases for fats, proteins and carbohydrates respectively. These are released into the duodenum via the duodenal ampulla, the same place that bile from the liver drains into • Pancreatic exocrine secretion is hormonally regulated, and the same hormone that encourages secretion (cholesystokinin) also encourages discharge of the gall bladder's store of bile • As bile is essentially an emulsifying agent, it makes fats water soluble and gives the pancreatic enzymes lots of surface area to work on

  23. The Large Intestine

  24. What goes wrong ? • Cancers of GI tract [ some 21% of all cancers are GI ones ] • Eating too much • Drinking too much • Diarrhea • Anorexia, nausea, vomiting, pain • Acid reflux • Gas, bloating, flatulence, heartburn • Irritable bowel syndrome • Dyspepsia • Ulcers • GI toxicity from NSAIDs • Hemorrhoids

  25. Medline Plus is a terrific allopathic source of GI issues & treatments

  26. Allopathy and your gastroenterologist ? Gastroenterology: • The branch of medicine dealing with the study of disorders affecting the stomach, intestines, and associated organs

  27. CPT Codes ICD-9 Codes HCPCS Supply Codes Modifiers RBRVS Values CCI Edits Medicare Guidelines Documentation Requirements National Coverage Decisions Local Medicare Review Policies Anatomy & Terminology Reference Evaluation & Management Guidelines Gastroenterology – complex field of medicine: Learn proven tips for correctly coding and billing dozens of Gastroenterology procedures and services including: Diagnostic Sigmoidoscopy Therapeutic Colonoscopy Diagnostic & Therapeutic Esophagogastroduodenoscopy (EGD) Endoscopic Examination--Upper Gastrointestinal Tract Modified Barium Swallow Studies Telemetric Gastrointestinal Capsule Imaging Gastric Bypass Surgery for Morbid Obesity

  28. Complex area is this system – consider allopathic text re drugs • Pharmacology in Nursing Practice · Introduction · Drugs Affecting the Immune System · Antivirals and Antifungals · Biologic Response Modifiers and Immunosuppressants · Antineoplastics · Drugs Affecting the Nervous System · Sympathetic Nervous System Agents · Parasympathetic Nervous System and Antiparkinsonism Agents · Central Nervous System Stimulants and Skeletal Muscle Relaxants · Anticonvulsants · Anesthetics · Anxiolytics, Antidepressants, Mood Stabilizers, and Antipsychotics · Drugs Affecting the Hematologic System · Agents Affecting Coagulation, Bleeding and Blood Formation · Drugs Affecting Blood Pressure and Blood Flow · Antihypertensives · Antilipidemics · Drugs Affecting the Cardiac System Agents Affecting Cardiac Output · Antiarrhythmics · Drugs Affecting the Respiratory System · Agents Affecting Upper Respiratory Disorders · Antihistamines · Antiasthmatics and Bronchodilators · Drugs Affecting the Endocrine System · Thyroid, Parathyroid Agents · Anterior Pituatory Hormones, Glucocorticoids, Mineralcorticoids, and Adrenal Hormone Inhibitors · Antidiabetics · Drugs Affecting the Gastrointestinal System · Agents Affecting Hyperacidity, Gastric Mucosa, Motility and Flatulance · Antiemetics, Emetics and Agents Used for Digestive Problems · Laxatives and Antidiarrheals · Drugs Affecting the Genitourinary Tract and Renal Disorders · Agents Used in Urinary Tract Alterations and to Improve Renal Output · Agents used in Renal Failure · Drugs Affecting the Reproductive System · Male and Female Hormones · Agents Affecting Uterine Motility, Fertility, and Infertility · Drugs Affecting the Musculoskeletal System · Anti-Inflammatory Agents · Drugs Affecting Nutrition · Agents Used for Nutritional Imbalances · Drugs Affecting the Sensory System · Ophthalmics and Otics · Dermatologics · Analgesics for Pain Relief

  29. Aspirin • BMJ 2000;321:1170-1171 ( 11 November 2001 ): • Aspirin, like all other drugs, is a poison: “We do not know who should be given what dose and for how long” • Long term use has resulted in severe GI hemorrhaging • Enteric or coated aspirin

  30. Burp Man A larger than life cartoon character drinks from a three-foot pop can pumped by visitor The stomach pressure increases until the character releases a giant burp, while a second interactive exhibit shows how the sphincter works Solutions from Sci North

  31. Gas Attack! Everyone loves to play pinball  Two custom pinball games are positioned in front of an animated pig sitting atop a pile of poop   The games are customized to teach children which foods create more gas in their bodies   The animated pig says funny quips at the start and end of each game Solutions from Sci North

  32. Text & Integrative Approaches to GI System • Complex terminology? • Know concepts, not host of medical terms • Concept of dysbiosis or dys-symbiosis • Dysbiosis is re indigenous “flora” of the gut start to promote illness [ NOT infection ] • Discusses regulation of GI flora by diet, motility, secretions like HCl, immunity, antibiotics, and probiotics

  33. Text & Intestinal Permeability & Gut Barrier Function • Nutrient absorption • How nutritional deficiencies affect absorption • Treatment of increased permeability (hyper-permeability) by removing the cause [ex: NSAIDs ] then nourishing the gut • Problems of fiber supplements

  34. Text and specific GI Disorders • discusses multi-component, integrative, evidence-based approaches to: ~ Inflammatory bowel disease ~ Crohn’s disease ~ Ulcerative colitis ~ “functional bowel disorders” • examines integrative therapies for Irritable Bowel Syndrome by asking series of questions • Finishes by looking at Acid-Peptic diseases like ulcers and the use of acupuncture, herbs, dietary regulation

  35. Next Day . . . • Chronic Fatigue • Oncology

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